Reconstruction of residual cleft nasal deformities in adolescents: Effects on social perceptions

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Purpose: The investigators hypothesized that a layperson's social perceptions of a primarily repaired adolescent cleft lip and palate (CL/P) patient is more favorable after definitive nasal reconstruction with regard to perceived social traits. Methods: The investigators implemented a survey comparing layperson's social perceptions of 6 personality traits, 6 emotional expression traits, and 7 perceptions of interpersonal experiences before and >6 months after definitive nasal reconstruction in CL/P adolescent subjects by viewing standardized facial photographs. The sample was composed of consecutive CL/P subjects treated by one surgeon using a consistent technique involving a rib cartilage caudal strut graft through an open approach. Five non-cleft adolescent subjects who underwent cosmetic rhinoplasty involving a septal cartilage caudal strut graft through an open approach were used as a comparison group. The outcome variable was change in 6 perceived personality, 6 emotional expression traits studied, and 7 perceptions of interpersonal experiences. Descriptive and bivariate statistics were computed (p-value <0.05). Results: The sample was composed of 10 consecutive CL/P subjects and 5 non-cleft adolescent comparison subjects. 500 respondents (raters) completed the survey. The respondents were 54% male with 56% age 25 to 34. After definitive cleft nasal reconstruction, study subjects were perceived to be significantly more attractive (p = 0.04) and less threatening (p = 0.04). They were also perceived as less angry (p < 0.01), sad (p < 0.01), or disgusted (p < 0.01) than prior to surgery. The subjects were also perceived to be less likely to have negative interpersonal experiences (p < 0.01). Conclusion: We confirmed that laypeople consistently report positive changes in adolescent CL/P subject's perceived social traits after definitive cleft nasal reconstruction. Overall, the positive changes were largely comparable between the cleft and non-cleft groups.

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